2025 HCPCS code V5214
(Active) Effective Date: N/A Revision Date: N/A Hearing Services - Hearing Aids Hearing Aids Feed
Supply of a binaural, in-the-canal (ITC/ITC) contralateral hearing aid system.
Modifiers may apply depending on the circumstances of service. Consult the CMS National Correct Coding Initiative (NCCI) edits for any applicable modifier rules.
The medical necessity for a binaural ITC/ITC contralateral hearing aid is established by documented hearing loss affecting both ears, specifically where there's a significant difference in hearing thresholds between the ears.The chosen device should be appropriate to address the patient's specific hearing loss characteristics and functional needs.
Audiologist or other qualified hearing healthcare professional responsible for fitting and dispensing the hearing aid.May involve an otolaryngologist for diagnosis and assessment of hearing loss.
In simple words: This code covers the cost of a special type of hearing aid that helps people with hearing problems in both ears.It has two parts, one for each ear, and is designed to fit inside the ear canal. It's specifically for people who hear better in one ear than the other.
This HCPCS code, V5214, represents the provision of a binaural (both ears), in-the-canal (ITC/ITC) contralateral hearing aid system.This type of hearing aid is typically used for patients experiencing hearing loss in one ear and some degree of loss in the other. The system utilizes two microphones; one positioned near the ear with better hearing and the other near the ear with more significant hearing loss.ITC hearing aids are custom-fitted to the individual patient's ear canal. The device's electronic components are housed in a hard plastic casing.The contralateral binaural system amplifies sound primarily for the ear with greater hearing loss, while also providing some amplification to the ear with less severe loss. Hearing loss may be congenital, or result from inner ear malformations, infections, trauma, or acoustic neuroma.
Example 1: A patient presents with moderate hearing loss in their right ear and mild hearing loss in their left ear.An audiologist determines that a binaural ITC/ITC contralateral hearing aid is the most appropriate solution. Code V5214 is reported., A patient with a history of noise-induced hearing loss experiences significant difficulty hearing in noisy environments. A binaural ITC/ITC contralateral system is prescribed to improve speech understanding, and code V5214 is reported., A patient is diagnosed with an acoustic neuroma affecting their right ear, leading to significant hearing loss.While surgery may be an option, the patient opts for a hearing aid to manage their hearing loss. A custom-fitted binaural ITC/ITC contralateral hearing aid is provided, and code V5214 is used for billing.
* Audiometric testing results demonstrating the degree and type of hearing loss in both ears.* Detailed description of the hearing aid, including manufacturer, model, and serial number.* Documentation of patient education regarding hearing aid use and maintenance.* Verification of proper fitting and functionality of the device.
** This code is for the supply of the hearing aid. Separate codes may be necessary for fitting and other related services.
- Payment Status: Active
- Modifier TC rule: No TC modifier is applicable.
- Specialties:Audiology, Otolaryngology
- Place of Service:Office, Clinic